That’s a long list - as one would expect in an eco-econ world where we have to treat economies as ecologies. It takes a lot to change a self-correcting system.

I think we can add more though - including the intersection of demographics and medicine.

Once upon a time, as “recently” (cough) as when I started medical school in 1982, parents died in their 60s and 70s. They weren’t as vigorous as today’s 70 yo’s but they weren’t particularly frail either. They ate poorly, smoked and exercised little — but that’s not enough to make someone frail. It just means that elders died relatively quickly of cancer, heart disease, and organ failure. Dementia was starting to become more common, but it wasn’t universal.

Today’s Boomer parents are different. They stopped smoking 20 or 30 years ago. They’ve had more education and they’ve benefitted from bypass surgery and far better medications for lipid and blood pressure control. Their diets are lousy and they never exercised much — but they’re not nearly as obese as we will be.

The frailty burden is genuinely new. It’s not big enough to explain all of our economic transformation, but I think it plays a significant role.

Fortunately, there’s an obvious fix - and an investment opportunity.

I expect to see massive solar powered robotic dementia care facilities opening across the empty spaces of America — probably as extensions of Google’s data centers. With robotic caretakers, waste water recycling, soy lent green synthetic protein, and high bandwidth connections to companion AIs and VR-integrated remote children this should be quite pleasant.